Skin cancer is the commonest type of cancer in Ireland, according to statistics provided by the National Cancer Registry. The incidence is increasing and approximately 8,000 cases of non-melanoma skin cancers are diagnosed in this country every year.

Research shows that 90 percent of all skin cancers are caused by the sun's ultraviolet (UV) rays and can be prevented by taking the proper precautions against sun damage. Contrary to popular belief, evidence indicates that skin cancer is caused by over exposure to the sun's rays not the depletion of the ozone layer.

Irish people are particularly vulnerable to sun damage because of our pale skin. This damage is permanent and irreversible. It also accumulates. In other words, damage to the skin in one year is added to damage done in previous years. This explains why skin cancer is more common among the elderly; one in every six men and one in every seven women will develop skin cancer by the age of 74 years.

In Ireland, from April to September, the sun is particularly damaging. At this time we all spend more time out of doors and are exposed to the sun's UV rays for longer periods. It is therefore necessary to protect ourselves so that we can enjoy the sun without damaging our skin.

How does the sun damage my skin?

UV Rays

The sun produces Ultraviolet Radiation of which two types reach the earth's surface - UVA and UVB. Both UVA and UVB are now known to cause skin cancer.

UV rays are all not bad. In fact, they are needed by the body to activate vitamin D, to kill certain germs and to boost our mood. However, overexposure to UV rays damages the skin irreparably.

UVA radiation

UVAs account for about 95 percent of all ultraviolet energy. Unlike UVBs, which peak in intensity from 11am to 3pm in summer, UVAs release energy throughout the daylight hours. They have the power to penetrate deep into the deep layers of the skin (dermis), and cause permanent harm to our DNA, as well as to the elastin and collagen fibres that make skin supple and firm, resulting in premature ageing and skin cancer.

While UVAs don't cause painful sunburn, their effects are very real and long-lasting.

UVAs can pass through glass - windshields and windows don't block them!

UVB radiation

UVB is the most harmful type of ultraviolet radiation, causing burning and skin cancer. To put it simply, UVBs "roast" your skin. Unlike UVAs, UVBs do not enter deep into the skin's layers but they can damage the DNA at the heart of skin cells and are one of the foremost causes of skin cancer.

By triggering your skin's natural protection process, UVBs are also responsible for producing that golden tan we all seek. A tan is the skin's natural way of protecting itself against these harmful UV rays.

However, you should bear in mind that these self-defence systems are thrown out of balance when overworked by repeated and prolonged exposure to the sun.

Remember! A tan is a sign that damaged skin is trying to protect itself from the sun's ultraviolet rays. Even when you have a suntan, you can still get sunburn.

What are the signs of sun damage?

Signs of sun damage are not always immediately apparent. The process may be summarised as follows:

1. When stimulated by UVBs, the skin's outer layer thickens, making it harder for UVBs to penetrate the surface. Scientists call this process hyperkeratosis.  
2. Sunlight triggers the production of melanin, the "tanning pigment." This helps you develop a natural tan to protect the skin's vulnerable lower layers. By the time your tan develops, your skin has already suffered UV attacks.  
3. Many skin cells die as a result of their exposure to UV radiation and need to be removed by the body. Langerhans cells increase in number to remove the dead skin cells (your skin may be peeling at this stage) but unfortunately these cells have little resistance to the sun itself.
4. Over a period of time, the DNA of the skin cells is damaged by the UV radiation and cancer cells may begin to form.

 

Immediate effects

Skin reddens.
Skin colour deepens.

Delayed effects

Sunburn appears four hours after exposure.
Skin begins to look tanned after two or three days.
The skin's upper layers thicken.

Long-term effects

Wrinkles and other signs of premature ageing.
Cancers may develop

Who is at risk?

You don't have to be a sun worshipper to be at risk from damaging effects of the sun; everyone who is exposed to the sun's UV rays is at risk.

People who work outdoors such as builders, farmers, fishermen and gardeners and those who play outdoor sports such as golf and football, need to take additional precautions.

When children are over-exposed to the sun in their early years, the risk of developing skin cancer later in life is increased.Children's skin is very sensitive to the sun's rays. All children, whether they tan easily or not, should always be protected.

Any light surface, especially sand and snow, reflects UV rays. This reflected ultraviolet radiation intensifies the amount of radiation reaching your skin and means you burn faster. Fresh snow reflects up to 80 percent of the sun's rays. Skiing enthusiasts should be particularly careful to protect their eyes and exposed skin.

Ultraviolet rays are at their strongest under a clear sky, even if the temperature is low or the wind makes you feel cold. Cloud cover does reduce ultraviolet levels but not completely. It is still possible to get sunburned under thin cloud cover.

Take particular care if you:

• Have pale and freckled skin that doesn't tan or burns before it tans.
• Have red or fair hair and light coloured eyes.
• Have a large number of moles (50 or more).
• Burn easily, have a history of sunburn or have already had skin cancer.

Watch out for the sunburn forecast!

The sunburn forecast is produced by Met Éireann in summer months and warns when UV levels are likely to be high. You may hear regional forecasts on local radio. The sunburn forecast estimates how long it will take for an average white skinned person to burn in the midday sun.

Remember that the sunburn forecast is only an estimate. Pale/fair skinned people and children who have sensitive skin will burn more quickly.

How can I help prevent sun damage?

Cover up!

• Wear a wide brimmed hat and a teeshirt.
• Wear sunglasses. A good pair of sunglasses will help protect your eyes from the sun. Look on the label and check the standard. (British Standard BS 27 24 19 87 or European Standard EN 1836)
• Stay in the shade between the hours of 11.00 am to 3.00 pm when the sun is at its strongest.
• Use sunscreen of sun protection factor (SPF) 15 or higher, with UVA and UVB protection and re-apply every two hours. Wearing sunscreen does not mean that you can stay out longer than recommended; it offers some protection, but should be used in conjunction with appropriate clothing.

The SPF number tells you how much longer you can stay in the sun without burning if you apply the sunscreen, which acts as a "block" to the sun's rays. For example, if you usually burn after 20 minutes of sun exposure, applying a sunscreen with an SPF of 15 gives you 15 times the protection. So you will be protected for up to 5 hours. (20 minutes x 15 SPF = 300 minutes or 5 hours.) Remember to re-apply the sunscreen regularly, paying particular attention to the neck, ears, nose and lips.
 

Children

Children's skin is very sensitive to the sun's rays. All children, whether they tan easily or not, should always be protected. It is essential that they wear appropriate cover-up clothing and sunscreen.

• A hat with a brim.
• A loose fitting teeshirt with collar and sleeves.
• If they are out in the sun between 11.00am and 3.00pm, they should wear a sunscreen of at least SPF 15 with UVA and UVB protection.  

Remember: Babies should be kept out of the sun entirely.

For children age six months and older, select an SPF of 15 or higher to prevent both sunburn and tanning. Choose a sunscreen that states on the label that it protects against both UVA and UVB rays (referred to as "broad-spectrum" sunscreen). To avoid possible skin allergy, avoid sunscreens with PABA, and if your child has sensitive skin, look for a product with the active ingredient titanium dioxide (a chemical-free block).

Sunscreens should not be used on babies younger than six months because their bodies may not be developed enough to handle sunscreen chemicals. Instead, use hats, clothing and shading to protect them. If you think your baby may need a sunscreen, check with your GP.

What can I do if my skin is already sunburned?

When your skin becomes sunburned, you usually experience pain and a sensation of heat. These symptoms tend to become more severe several hours after sun exposure. Some people may develop chills and skin rash.

Dry skin may become itchy and tight and burned skin typically begins to peel about a week or so after the sunburn. Do not scratch or peel off loose skin as the new skin underneath is vulnerable to infection.

To help alleviate pain and heat take a cool (not ice-cold) bath or apply wet compresses to the skin.

If the burn is bad consult your GP as he may prescribe a painkiller and some steroid-based cream to help skin heal faster.

Do not use petroleum jelly or similar products.

Avoid first-aid products that contain local pain relievers as they may cause skin irritation or allergy.

Once skin is damaged it is advised that you should stay in the shade and protect your skin from reflective sun radiation until it is fully healed and normal colour has been restored.